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House Call: Testing the best route to catch colon cancer early

If you were born in the mid- to late-1960s, you have turned 50 recently or will be doing so soon. Turning 50 is more than just the time when you get your first invitation to join AARP. It is also when most people should get their first screening for colon cancer.

For people who have ulcerative colitis, a close relative with colon cancer or polyps, Crohn’s disease and African-Americans who do not know their family history, screening at an earlier age may be appropriate.

An estimated 5 percent of people in the United States will develop colon cancer in their lifetime, making it the third most common cancer in the country. It is often, but not always, caused by lifestyle factors like eating a lot of red meat, smoking, being overweight and drinking alcohol.

Fortunately, colon cancer screening has been proven to save lives. So as you approach age 50, talk with your doctor about colon cancer screening. Here at Group Health, and in most practices, there are two options available to choose from.

A fecal immunochemical test (FIT) that is done once every year until age 75.

A colonoscopy that is done once every 10 years until age 75.

Both tests have potential advantages and disadvantages. But each is an effective method for screening and equally recommended by key professional organizations.

The advantages to FIT screening are that you avoid colonoscopy preparation and anesthesia. It is simple, done in the privacy of your own bathroom and requires a single stool sample that you collect yourself and mail to the lab. There is no time lost from work or risk of complications. The disadvantages are that it needs to be done every year and if you have a positive result, which happens 5 to 7 percent of the time, you will need to have a colonoscopy. I encourage patients who are not at increased risk due to family history or inflammatory bowel problems to go this route.

The advantages of a colonoscopy are that you may only have to have one every 10 years. Also, if polyps or anything unusual is seen during the procedure, the polyps can be removed and samples can be taken right then and there. Then a pathology lab examines everything to look for cancer.

Because most colon cancers start out as polyps that slowly progress to cancer, finding them is a reason to have a colonoscopy every three to five years. Other risk factors may necessitate more frequent screening too. The disadvantages to colonoscopy are that there is a chance your colon could be damaged during the procedure, the preparation is unpleasant and you must have a ride home because of the anesthesia used during the procedure.

I occasionally hear from my patients a type of false assurance that since no one in their family has had colon cancer, they don’t need to worry about it. Although a family history of colon cancer does increase ones risk, the vast majority of people who develop colon cancer do not have a family history of it.

The thought of being checked for any kind of cancer can make some anxious. It sometimes feels like we all know at least one person who has died from cancer; however, many people don’t realize that they probably know at least one cancer survivor, if not more than one. When detected early, the results from treatment of many types of cancer can be quite good. This is true of colon cancer, making the case for screening compelling. At its earliest stage, most people can be cured of colon cancer with surgery. Learn more about screening and prevention at the American Cancer Society website; search “colon cancer” at www.cancer.org.

Dr. Bob Riggs is a family medicine physician practicing at Group Health’s Riverfront Medical Center.


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